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Addressing Toxic Stress and Project DULCE

What is Project DULCE?

In recognition of the fact that families face a series of challenges for the first six months following the birth of a child, Project DULCE (Developmental Understanding and Legal Collaboration for Everyone) seeks to provide useful support for families by adding a trained family specialist to the team at the health centers where families already bring their babies for care. The DULCE Family Specialist (FS) provides support to families with infants in the clinic setting during routine healthcare visits and also offers home visits, telephone, email and text-messaging support.

Initial implementation of Project DULCE began in the spring of 2016 at seven clinic sites, in partnership with California First 5 commissions in Alameda, Los Angeles and Orange counties, the Children’s Service Council of Palm Beach County, Florida, and the Lamoille Valley Family Center in Vermont. Each community will implement DULCE in at least one clinic site serving 200 infants per year, and there will be a careful evaluation of the impact of DULCE on infants and families served, as well as on selected indicators of health care delivery and health/social services utilization.

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More information:

Guiding Principles

  • DULCE works to strengthen families by providing extra support during the critical first six months of an infant’s life
  • DULCE is embedded in the patient-centered medical home
  • DULCE works with families to empower them to solve their own problems: don’t do “for” families, do “with” families
  • DULCE eligibility is universal within the clinic, so there is no stigma attached to participation 


The DULCE intervention is based on the Strengthening Families Protective Factors approach to help families, drawing on and incorporating the following key components:

  • The support of the local Medical-Legal Partnership model to ensure that families have access to the resources they need
  • The Brazleton Touchpoints training to promote knowledge of child development and to strengthen collaborative parent, child and provider relationships
  • City and county partners who are members of the EC-LINC network
  • A quality improvement process for continuous practice and program improvement in the local context

The intervention model, based on the relationship between the DULCE Family Specialist and the family, builds upon the known trajectory of child and family development. The DULCE Family Specialists provide: 

  • Information on healthy child development,
  • Parenting support
  • Advocacy by connecting families to existing community resources available to them



For more information, contact:

Bob Sege, MD, PhD, DULCE Developer;
Patsy Hampton, DULCE Program Manager; 

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